In surgical, anesthesiologic and internal medical practice, the infusion of solutions containing hexoses, especially glucose and fructose, of different concentrations, is widely used.
This administration has several purposes: in the first place, the large quantities of water which are thereby directly introduced into the veins compensate for the normal oral intake of liquids, which is often impaired or contra-indicated in patients who have recently undergone a surgery and in other severe cases; it also permits an equilibration of the water metabolism in order to obtain a satisfactory elimination of toxic catabolites which are abnormally accumulated or produced.
Drip infusions are, therefore, administered whenever a dehydrated patient needs an immediate supply of water or when an activation of the toxic catabolite elimination is required by increased diuresis; for example, drip infusions are used in cases of severe infectious diseases, especially when associated with hypotension, in toxic states, in states of shock, during surgery and in post-operative periods. Especially good results are obtained in pediatric toxic states, in cases of acute diarrhoea and in cases of infectious diseases.
A further object of the drip infusion of hexoses is that of compensating the volumetric deficit following both traumatic and surgically spontaneous hemorrhages, which is a deficit which should be immediately compensated in order to avoid irreparable damage to the patient.
The third object which is strictly related to the chemical nature of the drip infusions themselves, is that of supplying easily utilisable metabolites, usually hexoses, of high calorific value.
Since, as is known, glucides provide an immediate source of energy, glucose solutions administered by infusion constitute a ready source of calories, which is a very important fact because patients treated by infusions often cannot be fed. Furthermore, hexoses, and especially glucose, represent the key substances of three metabolic systems, namely, glucidic, proteic and lipid metabolism; they are used in the synthesis of glycogen, the anti-toxic action of which at the level of the liver cell is very well known and the decrease of which occurs during anesthesia; starting from glucose, d-ribose is anabolised, this being a pentose which participates in the structure of nucleotides and nucleic acids and another glucide, i.e. galactose, is present in the molecules of cerebrosides molecules. In other words, glucides fulfil essential structural and metabolic functions in cells and organs, as well as in the functions thereof.
Infusions of carbohydrates are administered in order to supply the organism with energy and to correct the intermediate metabolic processes which have been altered, for example, by the use of anesthetics, which is shown by an increase of ketonic bodies in the blood.
However, the administration of the ordinary glucose infusions is not always free from side effects; one of these is the increase of the blood sugar level followed by glycosuria, which is an indication of a defective metabolic utilisation of the glucides injected. Although this glycosuria is not great, it cannot be clinically underestimated since it may cause, among other things, an abnormal increase in diuresis, which may, in turn, lead to cellular dehydration and sodium depletion. Although the stimulation of diuresis is advisable in cases of water retention, it is, however, harmful to patients showing hypotension, water inbalance, hemorrhage and the like, since rehydration of the patient, which is one of the objects of the administration, would be impaired.
It is an object of the present invention to provide new compositions which overcome the above-mentioned disadvantages which arise in the oral and parenteral administration of glucides.